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Does Better Disease Management in Primary Care Reduce Hospital Costs?

Author

Listed:
  • Mark Dusheiko

    (Centre for Health Economics, University of York, UK)

  • Hugh Gravelle

    (Centre for Health Economics, University of York, UK)

  • Stephen Martin

    (Department of Economics, University of York, UK)

  • Nigel Rice

    (Centre for Health Economics, University of York, UK)

  • Peter C Smith

    (Imperial College Buisiness School, UK)

Abstract

We apply cross-sectional and panel data methods to a database of 5 million patients in 8,000 English general practices to examine whether better primary care management of 10 chronic diseases is associated with reduced hospital costs. We find that only primary care performance in stroke care is associated with lower hospital costs. Our results suggest that the 10% improvement in the general practice quality of stroke care between 2004/5 and 2007/8 reduced 2007/8 hospital expenditure by about £130 million in England. The cost savings are due mainly to reductions in emergency admissions and outpatient visits, rather than to lower costs for patients treated in hospital or to reductions in elective admissions.

Suggested Citation

  • Mark Dusheiko & Hugh Gravelle & Stephen Martin & Nigel Rice & Peter C Smith, 2011. "Does Better Disease Management in Primary Care Reduce Hospital Costs?," Working Papers 065cherp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:65cherp
    as

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    File URL: http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP65_Disease_management_in_PC_reduce_hospital_costs.pdf
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    References listed on IDEAS

    as
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    Citations

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    Cited by:

    1. Jasmin Kantarevic & Boris Kralj, 2013. "Link Between Pay For Performance Incentives And Physician Payment Mechanisms: Evidence From The Diabetes Management Incentive In Ontario," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1417-1439, December.
    2. Griebenow, Malte, 2023. "Should physicians team up to treat chronic diseases?," Journal of Health Economics, Elsevier, vol. 89(C).
    3. Mauro Laudicella & Paolo Li Donni, 2022. "The dynamic interdependence in the demand of primary and emergency secondary care: A hidden Markov approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(3), pages 521-536, April.
    4. Islam, M. Kamrul & Kjerstad, Egil, 2017. "Is incentivizing by subsidizing a better way of managing chronic health conditions?," Working Papers in Economics 12/17, University of Bergen, Department of Economics.
    5. Johar, Meliyanni, 2012. "Do doctors charge high income patients more?," Economics Letters, Elsevier, vol. 117(3), pages 596-599.
    6. Matteo Lippi Bruni & Irene Mammi, 2017. "Spatial effects in hospital expenditures: A district level analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 63-77, September.
    7. Iezzi, Elisa & Lippi Bruni, Matteo & Ugolini, Cristina, 2014. "The role of GP's compensation schemes in diabetes care: Evidence from panel data," Journal of Health Economics, Elsevier, vol. 34(C), pages 104-120.
    8. Jemimah Ride & Panos Kasteridis & Nils Gutacker & Hugh Gravelle & Nigel Rice & Anne Mason & Maria Goddard & Tim Doran & Rowena Jacobs, 2023. "Impact of prevention in primary care on costs in primary and secondary care for people with serious mental illness," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 343-355, February.
    9. Kongstad, L.P. & Mellace, G. & Olsen, K.R., 2016. "Can the use of Electronic Health Records in General Practice reduce hospitalizations for diabetes patients? Evidence from a natural experiment," Health, Econometrics and Data Group (HEDG) Working Papers 16/25, HEDG, c/o Department of Economics, University of York.
    10. Fiorentini, Gianluca & Lippi Bruni, Matteo & Ugolini, Cristina, 2013. "GPs and hospital expenditures. Should we keep expenditure containment programs alive?," Social Science & Medicine, Elsevier, vol. 82(C), pages 10-20.
    11. Olsen, Kim Rose & Laudicella, Mauro, 2019. "Health care inequality in free access health systems: The impact of non-pecuniary incentives on diabetic patients in Danish general practices," Social Science & Medicine, Elsevier, vol. 230(C), pages 174-183.
    12. Mengping Zhou & Jingyi Liao & Nan Hu & Li Kuang, 2020. "Association between Primary Healthcare and Medical Expenditures in a Context of Hospital-Oriented Healthcare System in China: A National Panel Dataset, 2012–2016," IJERPH, MDPI, vol. 17(18), pages 1-12, September.
    13. Waibel, Christian & Wiesen, Daniel, 2021. "An experiment on referrals in health care," European Economic Review, Elsevier, vol. 131(C).
    14. Wiebke Schuettig & Leonie Sundmacher, 2022. "The impact of ambulatory care spending, continuity and processes of care on ambulatory care sensitive hospitalizations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1329-1340, November.
    15. Jeung-Hee Kim & Weon-Young Lee & Song Soo Lim & Young Taek Kim & Yeon-Pyo Hong, 2020. "Gender Differences in the Relationship between Type 2 Diabetes Mellitus and Employment: Evidence from the Korea Health Panel Study," IJERPH, MDPI, vol. 17(19), pages 1-11, September.
    16. Clémence Bussière & Nicolas Sirven & Thomas Rapp & Christine Sevilla‐Dedieu, 2020. "Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 508-522, April.
    17. David, Guy & Smith-McLallen, Aaron & Ukert, Benjamin, 2019. "The effect of predictive analytics-driven interventions on healthcare utilization," Journal of Health Economics, Elsevier, vol. 64(C), pages 68-79.
    18. Shen, Menghan & He, Wen & Li, Linyan, 2020. "Incentives to use primary care and their impact on healthcare utilization: Evidence using a public health insurance dataset in China," Social Science & Medicine, Elsevier, vol. 255(C).
    19. Lippi Bruni, Matteo & Mammi, Irene & Ugolini, Cristina, 2016. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Journal of Health Economics, Elsevier, vol. 50(C), pages 144-155.
    20. Timothy Simcoe & Maryaline Catillon & Paul Gertler, 2019. "Who benefits most in disease management programs: Improving target efficiency," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 189-203, February.
    21. Chuan De Foo & Shilpa Surendran & Geronimo Jimenez & John Pastor Ansah & David Bruce Matchar & Gerald Choon Huat Koh, 2021. "Primary Care Networks and Starfield’s 4Cs: A Case for Enhanced Chronic Disease Management," IJERPH, MDPI, vol. 18(6), pages 1-13, March.

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    More about this item

    Keywords

    Quality; disease management; primary care; hospital costs; ambulatory care sensitive conditions; preventative care.;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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    This paper has been announced in the following NEP Reports:

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